by Carolyn Thomas ❤️ Heart Sisters (on Blue Sky)
When you get together with your girlfriends, are there any conversation topics that are not open for discussion? Any that are off-limits? Any personal stories that you think are, well, just too personal to talk about to those women closest to you?
No, me neither.
Nowhere is this wide-open communication among friends more apparent than when sharing medical updates about each other. We want to share our medical news, or updates on that medical news, or our opinions about each others’ medical news. Detailed health updates are what my friend Dave likes to call “the organ recital”. But when it comes to serious health conditions, do you ever wonder if all that sharing is necessarily a good thing?
Immediately after I survived a misdiagnosed “widowmaker” heart attack in 2008, every detail of my story, every symptom, diagnostic test, hospital procedure, and “what the doctors said” seemed to spread like wildfire among my friends. By the time I was discharged home from the CCU (the hospital’s cardiac intensive care unit), everybody I knew, near and far, seemed completely up-to-speed on my story. Yet most people still wanted me to personally repeat my whole story for them. And I’ve observed the same thing happening this year since I was diagnosed with breast cancer on April 1st.
Linguist Dr. Deborah Tannen described this wildfire communication phenomenon beautifully in her must-read book on communication called You Just Don’t Understand. For example, Dr. Tannen suggests that women generally tend to communicate to connect emotionally, to express their feelings, or to build rapport with others.
By comparison, she found that men generally tend to communicate by sharing facts and figures – as in a report. She labels these communication style differences as “rapport-talk” and “report-talk”.
But I recently read a compelling essay arguing for NOT sharing quite so much – especially when you’re the patient. It was written by a woman living with chronic pain among other debilitating symptoms. Over one four-day period, she attended three significant social outings. Every outing required exhausting travel to and from each destination, plus long conversations to update her medical news for each group. After the third outing ended, she collapsed back at home – the beginning of a medical relapse that would last for many painful weeks, as she describes it:
“My body was done. I was depleted, mentally and physically. What I thought I was doing was sharing. Our culture encourages sharing. This is why we develop support networks. We ‘shine a light’ on hidden issues, we ‘air them out,’ we ‘come clean,’ we ‘get things off our chest.’ All of these idioms show the high regard we have for employing narrative as some kind of cure.
“But what if it’s not? What if focusing on our worst medical problems doesn’t make us feel better? I was aware of the perils of possible over-sharing with strangers, but I believed it would be different when I tell the people close to me the details of my medical news.
“It is different. It’s worse.”
“Talking about pain and trauma can actually cause pain and trauma. The truth is, sometimes talking about it is self-harm.”
That sentiment is also what Nova Scotia’s Dr. Barbara Keddy believes. The retired professor of nursing at Dalhousie University, and the author of Women and Fibromyalgia: Living With An Invisible Dis-ease – Dr. Keddy has herself lived with fibromyalgia for decades. And as if that’s not challenging enough, she’s also – like me – a heart attack survivor.
In her book, she wrote about a Toronto support group of women also living with fibromyalgia who meet regularly – but not, as you might expect, to discuss their shared illness, but wellness only. As she explains:
“Reliving past injuries of a physical or emotional nature only reactivates the nervous system. Instead, it is more important to recognize our reactions rather than the specific events related to the trauma.”
The question for many of us just might be how can we NOT share every update about one’s health with those who care about us?
As I wrote about in How Our Girlfriends Help Us Get Through the Toughest Times, social scientists tell us why so many women instinctively talk about what’s going on for us so freely compared to many men in our lives.
A landmark UCLA study in 2009 found that women respond to severe stress (such as enduring a serious health crisis) with a cascade of brain chemicals that cause us to seek and maintain friendships with other women.(1)
Dr. Laura Klein, one of the study’s authors, explained that researchers used to believe that when we experience such severe stress, both men and women trigger a hormonal cascade that revs the body to either stand and fight, or flee as fast as possible. This is the ancient fight-or-flight survival mechanism left over from pre-historic times when the first humans were chased across the plains by sabre-toothed tigers. But Dr. Klein points out that fight-or-flight response is what typically happens to men.
Dr. Klein and her team found that the influencing factor behind women’s unique stress reactions may be due to the hormone oxytocin (also known as the “love hormone”):
“It’s the body’s own wonder drug – released when we nurse our babies, for example, as well as during a woman’s stress response. It’s instinctual, it buffers the fight-or-flight response and it encourages us to tend children and gather with other women instead – what’s called our tend-and-befriend response to stress.”
This calming response does not occur in men, says Dr. Klein, because testosterone – which men produce in higher levels when under stress – seems to reduce the effects of oxytocin, while estrogen seems to enhance it.
So rather than toss those natural tend-and-befriend instincts, let’s consider how we might decide to modify our medical updates if we suspect that keeping up such updates are leaving us feeling drained or exhausted. For example:
♥ pick and choose carefully who to say what to (e.g. we don’t need to repeat every detail of every doctor’s visit to every casual acquaintance)
♥ we’re allowed to have private and personal thoughts
♥ we’re allowed to answer “”Pretty good, thanks!” when asked “How are you?” if we do not feel like chatting with this particular person
♥ we’re allowed to leave out any details we don’t want to talk about
♥ we’re allowed to delay answering questions about our diagnosis until we feel ready to share
♥ if we’re feeling truly overwhelmed, we can consider making an appointment to talk to a therapist, pastor or professional counsellor. Talk therapy can often be very helpful in gaining persepectives on what’s just happened to us, particularly in the early days post-diagnosis.
♥
1) Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Taylor, Shelley E.; Klein, et al. Psychological Review, Vol 107(3), Jul 2000, 411-429.
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Q: Which feels more comfortable for you: sharing medical news with friends and family, or disclosing less news?
♥
NOTE FROM CAROLYN: I wrote much more about sharing – and not sharing – details of a health crisis in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press). You can ask for it at your library, favourite bookstores (please support your local independent bookseller!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
Thanks for this article, Carolyn.
I find singing a way to recharge my equilibrium. I joined a senior community choir about five or six years ago. The choir isn’t oriented to performing, it’s a place for learning harmonies. We do perform a few times a year for the rest of those at the community senior centre. We are all energized by the music.
Singing helps us all to feel uplifted and our brains to function better.
10 benefits of singing https://www.seniorsguide.com/lifestyle/benefits-of-singing/
1. Improves respiratory health
2. Enhances mental well-being – Singing releases endorphins and oxytocin, hormones associated with happiness and reduced stress. It can effectively combat anxiety and depression, providing a natural mood booster.
3. Boosts immune system – Research suggests https://www.singfit.com/post/clinical-research-on-the-benefits-of-singing that singing can increase the production of antibodies and improve the body’s defense against infections, contributing to a more robust immune system.
4. Strengthens social bonds – Singing in a choir, band, or casual sing-along fosters a sense of community and belonging. These social connections play a significant role in enhancing overall mental and emotional well-being.
5. Enhances memory and cognitive function Learning lyrics and melodies stimulates brain activity, improving memory and cognitive abilities. This benefit can be particularly valuable for older adults wanting to maintain mental strength.
Related: How music benefits your brain https://www.seniorsguide.com/senior-health/music-ears-brain/
6. Improves posture and muscle tone Singing encourages better posture as it requires a straight back and open chest for optimal sound production. It also tones the muscles involved in breathing and facial expressions.
7. Facilitates emotional release Singing is a powerful form of emotional expression that allows individuals to convey their feelings and experiences, providing a therapeutic outlet for emotional release.
8. Boosts confidence Performing in front of others, even in informal settings, can significantly enhance self-esteem and confidence.
10 benefits of singing https://www.seniorsguide.com/lifestyle/benefits-of-singing/
1. Improves respiratory health
2. Enhances mental well-being – Singing releases endorphins and oxytocin, hormones associated with happiness and reduced stress. It can effectively combat anxiety and depression, providing a natural mood booster.
3. Boosts immune system
Research suggests https://www.singfit.com/post/clinical-research-on-the-benefits-of-singing that singing can increase the production of antibodies and improve the body’s defense against infections, contributing to a more robust immune system.
4. Strengthens social bonds Singing in a choir, band, or casual sing-along fosters a sense of community and belonging. These social connections play a significant role in enhancing overall mental and emotional well-being.
5. Enhances memory and cognitive function Learning lyrics and melodies stimulates brain activity, improving memory and cognitive abilities. This benefit can be particularly valuable for older adults wanting to maintain mental strength.
Related: How music benefits your brain https://www.seniorsguide.com/senior-health/music-ears-brain/
6. Improves posture and muscle tone
Singing encourages better posture as it requires a straight back and open chest for optimal sound production. It also tones the muscles ivolved in breathing and facial expressions.
7. Facilitates emotional release – Singing is a powerful form of emotional expression that allows individuals to convey their feelings and experiences, providing a therapeutic outlet for emotional release.
8. Boosts confidence – Performing in front of others, even in informal settings, can significantly enhance self-esteem and confidence.
Marty Layne
http://www.martylayne.com
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Hi Marty – what a comprehensive (and detailed) list of great reasons to take up singing!
I’ve been involved in choirs since my high school days and have also experienced many of those amazing benefits.
Take care. . . ❤️
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Hi Carolyn & Marty,
I’ve sung in a Church Choir since I was 9 years old, so for over 58 years! There is nothing better than being able to sing from your heart!
Singing has always been one of my “lifelines”. Through the last 5 years of medical H*** for my husband and me, my Choir was one of the few things that I did. I’m a soprano and even when others stopped wearing masks, I continued to sing masked and socially distanced behind the rest of the choir.
At one point, my husband was so ill that I absolutely couldn’t bring any viruses, especially COVID, home. Sometimes I couldn’t leave him to attend choir practice; but, our daughter, who is an RN, would come over on a Sunday morning so that I could go to Church.
As you said, the emotional and physical energy needed to repeat your story over and over again was too much.
However, I wanted people to be thinking and praying for my husband and me. It took a year to diagnose him with low adrenal function by which time he was down to 115 pounds and was wasting away! (Through this, I lost 25 pounds, 10 of which I had been trying to lose for a while! LOL) We had him on the waiting list for a nursing home!
Hydrocortisone has been like a miracle drug and he is back to his old 153 lb. weight and 90-95% of his former energy. He started getting better when I was diagnosed with breast cancer, had surgery, radiation, and subsequently developed a huge hematoma which I had surgically removed in June after suffering with it for 20 months.
So, again, I needed my friends to be praying for me. There is much more to this story, including our seeing first hand how broken our Health Care system is in Ontario, with wait times in our ER of 8-10 hours!
I had learned in 2010 when I had triple bypass surgery that my best method of informing family and friends was through emails.
I could tell my story once and then when I was finally able to safely get together with people or had the energy to talk on the phone, we could talk about other things.
For most of the past 5 years, the only people at my Church who knew about our health struggles were my choir, who needed to know why I sometimes missed practice and why I was singing masked behind the choir, a group of ladies who have continued to meet for coffee via ZOOM, which was started during COVID, and prayer chain groups.
I needed Church to be my Oasis of Tranquility where I could just be me and I could forget for a while what was happening and return home with renewed strength. Now that I’m better, I’ve sent a summary to the rest of my friends at Church so they could understand my “odd” behaviour, including having to be helped up and down the stairs when I was suffering from dizziness and brain fog following a 5 day stay in the hospital due to a severe bout of vertigo in April.
I also reached out to my friends via email when I was looking for advice about seeking a second opinion regarding my large hematoma. As a result, I found a breast specialist surgeon at Princes Margaret Hospital who was wonderful and I now feel like I’ve emerged out into the sunshine after 5 years of living in greyness!
We have 8 grandchildren ranging in age from 5 – 13, who have been a joy and a needed distraction. We can now enjoy them even more now that we have more of our energy back!
Being a retired Math teacher for whom detail is important. I would send more details to my family than to my friends who would patiently read my emails and send return emails of love and encouragement. I would often receive advice from people who had been through something similar.
Being a teacher, I had another motive, and that was to let others know about what my husband and I have been through in case they ever face something similar. Our GP now knows to check people’s cortisone levels when they display symptoms like my husband. I’m also going to become an Ambassador and and Advocate for our local hospital.
I’ve copied those emails into word documents with the thought of writing a book some day. I found writing them to be very therapeutic they allowed me to let go of the detail and focus on positive things.
People are all different and I know that what works for me wouldn’t work for everyone else. With my emails, I had to pick and choose how much detail to include for different groups. However, sometimes, I only had enough energy to compose one email and have now thanked my family and friends for tolerating my long emails and supporting us.
Sincerely,
Linda Vardy
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Hello Linda – my apologies for somehow skipping my reply to your wonderful comment from way back on August 18th!! How on earth did I miss that? Your five years of grey must have been such a nightmare for both you and your husband with such serious health crises (him waiting a year for an accurate diagnosis, losing all that weight – and even considering a move to a nursing home!?) Just dreadful! But how wonderful that the Hydrocortisone turned the corner for him. Meanwhile, you too were suffering through breast cancer, surgery, radiation and that huge hematoma! You have officially reached your lifetime quota of awful medical crises!! I’m so glad you are “back in the sunshine” and have your energy back – I really hope the years ahead will be even better than you and your husband could wish for.
And I know you will be a stellar Ambassador and Advocate for your local hospital, Linda! Good luck and take care. . . ❤️
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I tend to be a private person so sharing fewer details is generally better. I might talk to friends and family about how I feel about a medical situation (anger, frustration, etc) but generally not the specific details.
Sharing details has been reserved for a peer support group that I was a part of, and for psychotherapy, both of which have helped me process those details in a meaningful way. If I am sharing, it’s because I’m trying to make some sense of it or empathize with someone who has been through a similar experience.
Reliving past injuries can definitely cause harm if not done in an intentional way.
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Hello Kerry – I really identify with your criteria for safely sharing personal details (peer support group and/or psychotherapy) – and agree that both can be very useful when trying to make sense out of something that makes no sense – as well increasing our empathy skills.
I’ve also learned that not all close friends and/or family members are necessarily the most appropriate listeners when we do want to confide in someone. In my experience, the closer the family member, the more they want and need us to just get better following a frightening diagnosis. It can be very upsetting for some – ironically those closest to us – to be fully present when we’re scared or overwhelmed or not improving as they’d expected. I wrote more on this in my article called “Choose Your Listeners Carefully“.
Take care. . . ❤️
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Carolyn,
I have an unrelated question… Can you direct me to the article you wrote a while back that talked about how long it takes to recover from any invasive procedure, like cardiac Cath and stenting? I found it very helpful and could use a refresher.
Thank You
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Hi again Jill – I’m guessing that it might be the article about how soon heart patients are safely fit to drive? Maybe not (I have over 900 articles so far – along with fading brain power!) 😉 but here’s the link: the paragraph I’m thinking of starts with “Recommended wait times before driving…”
❤️
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Hello Carolyn,
My closest friends and family have learned over the years that my way of healing is to go inward, in quiet recluse, and allow the healing energies the body supplies us with to multiply and do their job.
What most people don’t understand is the energetic side of communicating with others. Many people are just morbidly curious, many people have thoughts and attitudes about illness and treatment and even if they don’t speak them, the energy is there and is directed at you and your illness.
Healing requires enough energy as it is, we do not need other people’s ideas, beliefs or even sympathy raining down on us. Nor do we need to use our energy to foster some sort of response.
There are special people that can just sit, quietly and exude love and compassion. Those, I might choose to be around.
Your list, topped with “Pick carefully” is sage advice!
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Hello Jill – you raise such a good point when you mention what should be obvious to our own friends and family members who KNOW US, and should NOT be the ones expecting us to “use our energy to foster some sort of response”. I had an odd experience very recently when a neighbour (who had just learned about my breast cancer diagnosis) ran into me in the hallway, gave me a spontaneous hug, and then just stood there staring at me, clearly upset, but unable to speak or move! I ended up reassuring HER! (“It’s okay Elizabeth, I’ll be alright…”)
Healing DOES require energy, which is why “choose your listeners carefully” is such an important personal decision.
Take care. . .❤️
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